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Life before myocardial infarction - a qualitative study of middle-aged women
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
Center for the Study of Culture and Health, University of Turku, Finland.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-4224-1032
2014 (English)In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 6, 2765-2774 p.Article in journal (Refereed) Published
Abstract [en]

The health burden of myocardial infarction is rising for middle-aged women and they are underrepresented in research of cardiovascular diseases. The aim of this qualitative study was to explore how life had been for middle-aged women before they suffered a myocardial infarction (MI). Through a health care register, we identified all women (n = 46) under 65 years of age in a defined region in southeast Sweden who had suffered an MI the past 2 years and a strategic selection of n = 16 women from these was made. These selected women were interviewed and their narratives were interpreted by qualitative content analysis. The qualitative interviews generated five general themes: “Serious life events”, “Negative affectivity”, “Loneliness”, “Being a good girl” and “Lack of control”. The interviews revealed that many of these women had been exposed to extreme and repeated traumatic life events in their lives. Many had a cynical attitude towards others, felt lonely and experienced a lack of social support. Many of these women endeavored to “be a good girl”, which was a special psychosocial phenomenon found. This study uncovered that these women before they suffered an MI were affected by a variety of psychosocial factors. The study stresses the importance of psychosocial risk factors in the assessment of middle-aged women’s risk profile for MI. A general conclusion for clinical practice is that in the assessment of the individual risk for myocardial infarction for middle-aged women, potential psychosocial factors might also be considered.

Place, publisher, year, edition, pages
Wuhan, Hubei Province, China: Scientific Research Publishing, 2014. Vol. 6, 2765-2774 p.
National Category
Family Medicine
Identifiers
URN: urn:nbn:se:liu:diva-115734DOI: 10.4236/health.2014.620316OAI: oai:DiVA.org:liu-115734DiVA: diva2:796178
Available from: 2015-03-18 Created: 2015-03-18 Last updated: 2017-09-18Bibliographically approved
In thesis
1. Risks for cardiovascular disease in middle-aged women in different social environments
Open this publication in new window or tab >>Risks for cardiovascular disease in middle-aged women in different social environments
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The importance of the social environment and human life conditions for public health was early recognized in community medicine. Despite major reductions in recent decades, cardiovascular diseases (CVD) is one of the leading causes of mortality and morbidity for both genders in all European countries. 

Aim: The overall aim of this thesis was to increase our knowledge of factors in the social environment and of individual psychosocial factors that could explain why some women in working ages are affected by cardiovascular diseases.

Methods: The Swedish sample comes from the urban population in two major cities in a region in the south-east of Sweden, the Twin cities. According to their social history they could be labelled a “blue-collar” and a “white-collar” city. Cardiovascular morbidity data in all papers for the Twin cities was derived from a computerized population-based administrative Health Care Register (HCR). In Paper IV, we made a comparative study between Sweden and Scotland, the Scottish data comes from the Scottish Health Survey.

Results: In Paper I, the cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women were significantly higher in the population of the blue collar city in all ages and for both sexes. The qualitative interviews of women after an MI, in Paper II, the findings revealed a broad picture of social factors, life circumstances, personalities and, not least, psychosocial factors that are important to middle-aged women who have suffered an MI. Paper III demonstrated that women with a high level of the personality trait “being a Good Girl” reported significantly more psychosocial risk factors for CVD and more commonly report chest pain without seeking medical care, no increased incidence for various CVD-diagnoses were found. The comparative study (Paper IV) clearly showed that Scottish middle-aged women are – relative to Swedish women - particularly affected by a worse profile of CVD risks, even after adjustment for education.  

Conclusions: The social environment is of importance for cardiovascular risks and cardiovascular morbidity and mortality. This has been shown in Swedish Twin cities context and also in comparative studies between Swedish and Scottish women. The thesis gives strong implications for an upstream public health approach initiating long-term community intervention program in the blue collar city and among Scottish middle-aged women.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2017. 91 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1577
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-140934 (URN)10.3384/diss.diva-140934 (DOI)9789176854976 (ISBN)
Public defence
2017-09-29, Belladonna, ing 76/78, Campus Valla, Linköping, 13:00 (English)
Opponent
Supervisors
Funder
The Swedish Heart and Lung Association, E136-15/E106/13
Available from: 2017-09-18 Created: 2017-09-18 Last updated: 2017-09-18Bibliographically approved

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Wennerholm, CarinaJern, MichaelaFaresjö, Tomas

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